_The Personhood Initiative

Bill Fortenberry

One of the most ardently presented pro-choice arguments is the claim that abortion is sometimes necessary in order to save the life of the mother.  This argument has been very effective over the years and has been used to persuade pro-life politicians to include a life of the mother exception to nearly every law designed to limit abortions.  Very few politicians realize that the inclusion of a life of the mother exception is a tacit admission that the unborn child is not a person.  Even more rare is the politician who realizes that Justice Blackmun cited this very exception to justify his decision in Roe v. Wade.

"If this suggestion of personhood is established, the appellant's case, of course, collapses, for the fetus' right to life would then be guaranteed specifically by the (Fourteenth) Amendment ... When Texas urges that a fetus is entitled to Fourteenth Amendment protection as a person, it faces a dilemma. Neither in Texas nor in any other State are all abortions prohibited. Despite broad proscription, an exception always exists. The exception contained in Art. 1196, for an abortion procured or attempted by medical advice for the purpose of saving the life of the mother, is typical. But if the fetus is a person who is not to be deprived of life without due process of law, and if the mother's condition is the sole determinant, does not the Texas exception appear to be out of line with the Amendment's command?" [ROE v. WADE, 410 U.S. 113 (1973)]

If we are ever to succeed in overcoming the Roe decision, then it is imperative that we answer the dilemma presented by Justice Blackmun.  How can a personhood amendment be reconciled with the need to protect the life of the mother?

The solution to this dilemma is actually quite simple, but the majority of Americans find it so contrary to their perspective  that they tend to reject it without even the slightest consideration.  Surgeon General C. Everett Koop answered the dilemma in this way: “Protection of the life of the mother as an excuse for an abortion is a smoke screen. In my thirty-six years in pediatric surgery I have never known of one instance where the child had to be aborted to save the mother's life.”[1]  Dr. Koop has been made the subject of much ridicule since making that statement, but is it possible that he is right?  Most Americans would answer with an emphatic, “No,” but let us not be so hasty.  Let’s take the time to consider the evidence before we arrive at our conclusion.

Without a doubt, the most frequently presented example of a case in which the mother’s life may be in danger if an abortion is not performed is the case of an ectopic pregnancy.  An ectopic pregnancy is a pregnancy in which the child is growing in an area of the mother’s body other than the womb.  In most of these cases, the child is found to be growing in one of the mother’s fallopian tubes.  Occasionally the child will grow in the mother’s abdominal cavity, and on very rare occasions he will begin to develop inside of one of her ovaries.  These pregnancies are generally assumed to be fatal unless an abortion is performed, and the explanation is given that it is better to save the mother by killing the unborn child than to do nothing and allow both of them to die.

When we take the time to examine scientific studies of ectopic pregnancies, however, an entirely different picture comes to light.  To begin with, let’s consider the Center for Disease Control estimate of 108,800 ectopic pregnancies in America in 1992.[2]  According to the above assumption, this number is equal to the number of women who would have died if abortion had not been available to them as a treatment.  The CDC also reported an average of 26.3 ectopic related deaths per year from 1991 – 1999,[3] and the proponents of abortion tout these figure as proof that abortion is necessary to save thousands of lives per year.  However, that boast is made in ignorance of several additional studies.

The actual danger that an ectopic pregnancy poses to the mother is that of a tubal rupture or some other kind of hemorrhage which could cause the mother to lose a vital amount of blood.  However, the Cleveland Clinic Foundation reported that, from 1983 to 1996, they treated 62 patients who had experienced a tubal rupture.[4]  Over a fourteen year period, this single hospital treated 4.4 ruptured ectopic pregnancies per year, but the CDC only reported 26.3 ectopic related deaths per year.  If tubal ruptures were definitely fatal, then that would mean that this one hospital has witnessed 1/6 of all the ectopic related deaths in America.  While this would be highly unlikely, it is certainly not impossible, and so we turn to the next study on our list.

The entire southern region of Israel only saw 13 pregnancy related deaths over a 23 year period extending from 1969 to 1991. [5]  This comes to an average of .57 deaths per year.  In 1992, the Soroka University Hospital in Be’er Sheva reported 148 ruptured ectopic pregnancies.[6]  If we assume that the rate of maternal deaths for this region did not experience a drastic increase from 1991 to 1992, and if we assume that every single one of those .57 deaths occurred at this one hospital and that all .57 of them were the result of ruptured ectopic pregnancies, we still would only be able to calculate a .4% chance that a ruptured ectopic pregnancy will cause the death of the mother.  If 99.6% of all the ruptured ectopic pregnancies in southern Israel do not result in the death of the mother, then the claim that abortion must be performed in order to prevent death from a ruptured ectopic pregnancy is undoubtedly spurious.

Of course, this then begs the question of how these mothers were able to survive such an ordeal.  Nearly a century ago, a doctor in Germany reported success in using autotransfusion to treat ruptured ectopic pregnancies.[7]  Autotransfusion involves siphoning the blood which has spilled into the abdominal cavity, running it through a filter and then pumping it back into the mother’s body.  In 2002, a worldwide study of 632 ruptured ectopic pregnancies treated with autotransfusion reported only a single instance of death.[8]  That’s a success rate of 99.84%.  This study demonstrates that this non-abortive treatment is more successful than the preferred abortion method which has a success rate of just 99.6%.[9]

Clearly we can see that ectopic pregnancies are not fatal to the mother, but what of the child?  Those confronted with this evidence will undoubtedly ask if it is ethical to cause the mother to experience the pain of an ectopic pregnancy if there is no hope of her child’s survival.  However, the assumption that the child cannot survive an ectopic pregnancy is just as groundless as the same claim about the mother.

There have been many reports of successful ectopic pregnancies.  In September of 1999, Ronan Ingram was successfully delivered via c-section.  Ronan had implanted in one of his mother’s fallopian tubes which subsequently ruptured as he grew into the abdominal cavity.[10]  In May of 2008, Durga Thangarajah was born after spending a full nine months in her mother’s ovary.[11]  Sage Dalton was born in July of 1999 after developing in the amniotic membrane outside her mother’s womb.[12]  Billy Jones was born in 2008 after developing in his mother’s abdominal cavity.[13]  The reports go on and on.[14] [15] [16] [17] In spite of all the claims to the contrary, doctors are constantly being amazed by the unborn child’s ability to develop and grow in spite of his location within his mother’s body.

Ectopic pregnancies are neither fatal for the mother nor necessarily for the child.  The mother’s survival is almost certain, and the survival of the child is at least possible if not likely.  So what does this mean to the pro-life movement?  It means that Dr. Koop was correct.  The personhood of the unborn child does not conflict with the need to protect the life of the mother for the simple reason that abortion is never necessary for that protection.




[1] C. Everett Koop, M. D., "A Physician Speaks About Abortion," http://www.pathlights.com/abortion/abort08.htm (accessed December 3, 2011)

[2] Center for Disease Control, “Current Trends Ecoptic Pregnancy.” http://www.cdc.gov/mmwr/preview/mmwrhtml/00035709.htm (accessed December 3, 2011)

[3] Center for Disease Control, “Pregnancy-Related Mortality Surveillance,“ http://www.cdc.gov/mmwr/preview/mmwrhtml/ss5202a1.htm (accessed December 3, 2011)

[4] Tommaso Falcone, Edward J. Mascha, Jeffrey M. Goldberg, Lourdes L. Falconi, Geeta Mohla, and Marjan Attaran. “A Study of Risk Factors for Ruptured Tubal Ectopic Pregnancy,” Journal of Women's Health. May 1998, 7(4): 459-463. doi:10.1089/jwh.1998.7.459.

[5] J. R. Leiberman, D. Fraser, M. Mazor and M. Glezerman, “Maternal Mortality in Southern Israel,” Archives of Gynecology and Obstetrics, 252(4): 203-207, DOI: 10.1007/BF02426359

[6] M. Glezerman, F. Press and M. Carpman, "Culdocentesis is an Obsolete Diagnostic Tool in Suspected Ectopic Pregnancy," Archives of Gynecology and Obstetrics, 252(1): 5-9, DOI: 10.1007/BF02389600

[7] S Edwin Duncan, Gerald Klebanoff, Waid Rogers, "A Clinical Experience with Intraoperative Autotransfusion," Annals of Surgery 180(3): 296-304,

[8] D.O Selo-Ojemea, J.L Onwudea, U Onwudiegwu, "Autotransfusion for Ruptured Ectopic Pregnancy," International Journal of Gynecology & Obstetrics, 80(2): 103-110, DOI:10.1016/S0020-7292(02)00379-X

[9] Clarisa R Gracia M.D.a, Hillary A Brown M.D.b, Kurt T Barnhart M.D.M.S.C.E., "Prophylactic methotrexate after linear salpingostomy: a decision analysis," Fertility and Sterility, 76(6): 1191-1195, DOI:10.1016/S0015-0282(01)02906-5

[10] BBC News, "Doctors hail 'miracle' baby," http://news.bbc.co.uk/2/hi/health/443373.stm (accessed December 3, 2011)

[11] Rebekah Cavanagh, "Miracle baby may be a world first," NT News, May 30th, 2008, http://www.ntnews.com.au/article/2008/05/30/4247_ntnews.html (accessed December 3, 2011)

[12] The American Registry for Diagnostic Medical Sonography, "Broadcast of “Miracle Ectopic Pregnancy” Brought Quick Response by ARDMS," Registry Reports, XVI(5):1

[13] Laura Collins, "Miracle baby Billy grew outside his mother's womb," http://www.dailymail.co.uk/femail/article-1050942/Miracle-baby-Bill... (accessed December 3, 2011)

[14] Janusz J. Godyn MD, Anup Hazra MD, Vito M. Gulli MD, "Subperitoneal placenta accreta succenturiate in the case of a successful near-term extrauterine abdominal pregnancy," Human Pathology (2005) 36: 922– 926, DOI:10.1016/j.humpath.2005.05.020

[15] L. Badria, Z. Amarin, A. Jaradat, H. Zahawi, A. Gharaibeh, A. Zobi, "Full-term viable abdominal pregnancy: a case report and review," Archives of Gynecology and Obstetrics, (2003) 268: 340-342, DOI: 10.1007/s00404-002-0363-y

[16] Anjali S. Kawthalkar, Madhuri S. Gawande, Sheela H. Jain, Sulabha A. Joshi, Sunita D. Ghike, Anuja V. Bhalerao, "Rare case of live birth in a ruptured rudimentary horn pregnancy," Journal of Obstetrics and Gynaecology Research, 37(8): 1169–1172, DOI: 10.1111/j.1447-0756.2010.01497.x

[17] Lucia Muehlparzer, Wolfgang Arzt, Thomas Ebner, Gernot Tews, "Secondary abdominal pregnancy with live birth," Acta Obstetricia et Gynecologica Scandinavica, 90(3): 288, DOI: 10.1111/j.1600-0412.2010.01041.xEctopic Personhood

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